Individual provider Active NPI

Tessa Rollenhagen, MS OTRL

  • Occupational Therapist
  • Cedar Springs, MI
National Provider Identifier
1811343536
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009462 Issued in MI
Practice address
308 S Main
Cedar Springs, MI 49319-8925
Phone
(616) 696-6555
NPI assigned
May 12, 2016
Last updated
May 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201009462 MI Primary

Addresses

Primary practice location

308 S Main
Cedar Springs, MI 49319-8925

Mailing address

308 S Main
Cedar Springs, MI 49319-8925
Phone (616) 696-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5201009462MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Northern PT, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1811343536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S MAIN",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493198925",
            "telephone_number": "616-696-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S MAIN",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493198925",
            "telephone_number": "616-696-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLENHAGEN",
        "first_name": "TESSA",
        "credential": "MS OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.